Memorial Service Pays Tribute to Anatomy Cadavers

(this story originally appeared in Synapse) by Yu Xie The Greek physician Claudius Galen (A.D. 131-200) was an important contributor to the science of anatomy. He was one of the first to accurately observe what he saw in expertly dissected animals. He applied this information, sometime erroneously, to humans. When anatomical research stopped for many centuries, Galen's teachings remained the ultimate medical authority. It was only after human dissections resumed in the sixteenth century, that many of these 'truths' were overturned by the Flemish anatomist and physician, Andreas Vesalius (1514-1564), who reasoned that Galen's errors were due to having done only animal dissections, which often did not apply to human anatomy. Although these two great physicians disagreed on which organ is responsible for blood synthesis in the human body, they strongly agreed that learning anatomy through dissection is a unique, irreplaceable and privileged part of a physician's training. Here at UCSF, we see this belief continued through the graduate programs' anatomy curriculum as well as the well-attended UCSF Cadaver Memorial Service on May 11. For instance, medical students at UCSF receive approximately 115 hours of anatomy throughout the two-year essential core curriculum as well as the option to pursue an independent dissection elective in the third, fourth or resident years. Currently, these hours are largely spent on dissection supplemented by prosection. A prosection is an expertly pre-dissected model for students to view. However, there have been some large shifts in the way anatomy has been taught at UCSF. For over 20 years, the old curriculum was based on teaching anatomy through dissection. About five or six years ago, the curriculum changed to solely prosection, which many consider a more efficient process that leaves additional time to learn anatomy. However, two years ago, the curriculum was changed again to involve mostly dissection, which increases active learning, student interest and group work. Dr. Kimberly Topp, director of the medical curriculum's essential core anatomy content, is a strong proponent of integrating dissection and prosection to maximize the grasp of three dimensional anatomy, tissue properties, normal variations and instrumental skills, all the while maintaining students' curiosity. In my opinion, interactive learning by working through dissection is also the most vivid way to engrave the anatomy in a student's mind. Since UCSF is an extremely prestigious academic institution, it receives enough generous donations to allow students the privileged experience of learning anatomy through small group dissection. These groups are typically six students per cadaver and carefully work on the cadaver for eight months. In order to ease the students into the process of dissection, the face and extremities are covered and dissected last. The cadavers come to the students masked and anonymous, with only their gender, age and cause of death as ID. Students are first instructed on how to properly care for their cadavers. A strong sense of ownership and caring for the cadavers are forged over these months. Dr. Allan Basbaum, Professor and Chair of the Department of Anatomy at the University of California, manages the Willed Body Program, which supplies the cadavers used for anatomy. Numerous medical, pharmacy and physical therapy students go through human dissection in graduate school. However, we shouldn't forget this is still a process that initially feels unnatural to students. The on-campus Memorial Service conveys this message as well as offering an outlet for students to reflect on how much they've gained from this unique experience. This memorial service was chiefly organized and orchestrated by Brian Mohlenhoff (MS1) with the help of many of his classmates and faculty members. Mohlenhoff has an on-going research interest in studying the medical students' experience in medical school and has voluntarily spent months planning for this memorial service. First-year medical students and anatomy lab faculty members gathered together on this night to share poetry, book excerpts, songs, personal writings and prayers as a way to recognize the significant sacrifice the donors and their families made, the unique and unforgettable experience of human dissection, and most importantly, pay tribute to their first patient. Students also offered unique perspectives on how death and dying is addressed and carried out in their unique cultures. A wide range of how students and faculty deal with the concept of human dissection was exemplified in the ceremony. Beliefs of religion, reincarnation and karma were articulated. On a more basic level, other students felt the need to personify their cadaver by naming them. One faculty member voluntarily told the audience that she has donated her body to the UCSF Willed Body Program in hope to "contribute to students' education now, and in the future". By actively participating in the memorial service, students were able to personify the experience and bond in mutual support. Everyone who attended wrote personal messages to their cadaver. At the end of the ceremony, students and faculty members left these cards by the door. All remains, along with these farewell good wishes, are cremated and the ashes are scattered at sea. Yu Xie is a first-year medical student.